Inability To Urinate Post Op

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I recently had the Green light Laser Surgery.  I have been unable to urinate since then.  Everything they tried worked...ONCE!  Right after surgery I peed good then I had to force it out then that didn't even work.  Back to ER for cath.

Yesterday the cath came out and I was put on Bethanechol 25 mg 3X per day .  The first time I tried it it worked GREAT!  A real FIRE HOSE!  I thought, FINALLY, they have something that works.

Well, it stopped working yesterday afternoon and last night.  I happen to know for a fact that I produce 1,000 ml of urine over night. Sometimes as high as 1200.  It's morning and still no go which means my bladder is full.  It's off to the ER shortly.

I have asked several times to teach me self cath but they seen cold to the idea.

WHAT POSSIBLE REASON COULD THEY HAVE FOR THISC ATTITUDE?

Comments and suggestions welcome.

Tom

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  • Posted

    They may worry that you could damage their handiwork inside your urethra. They may be unwilling to accept that there are such easy ways to avoid further (costly) work on you.
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  • Posted

    Not being a mind reader, I'm not going to even guess as to why "they" are so resistant.  That said, and if I were in your situation, I would INSIST, that they teach me to self-cath, barring serious and compelling MEDICAL REASONS TO THE CONTRARY.    I have been doing it since August 2014, initially every time I had to pee, after my prostate shut me down, and now 2 X daily, post-Urolift (for permanently stretched-out bladder.  There are tricks to it; any of us can advise.  But going to the ER just to pee?  NO WAY!

    The brand recommended highly by me and others for ease of use:  SpeediCath hydrophilic.  

    DO NOT ACCEPT RUBBER CATHS!  Imho, medieval and potentially painful to use. Some nurses and uro docs still don't get that.  

    Good luck!

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  • Posted

    Tom I am sorry that the Green Light do not work..  Your doctor should be willing to help you.  It's a shame that you have to do this after the procedure.  Maybe you should have lood into something else.  Good luck  Ken
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  • Posted

    It may be time to let them explain what happened, what didn't happen, and what needs to happen next, to your lawyer.
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  • Posted

    First things first. Have you asked them why you can't urinate? My guess is it's due to swelling from the operation and hopefully will resolve in time. Either that, or your bladder has no tone (atonic/flaccid). Did they say anything about a flaccid bladder to you prior to the operation?

    If it's the former -- swelling-- then they might  have to use catheters until the swelling goes down. Sounds like they think it will be a quick fix (ER visit) because they haven't sent you home with a Foley.

    If the quick fix doesn't work this time, or they send you home with a Foley, self catherization is certainly an alternative option. One that personally I would prefer, and in fact an option I chose over a Foley several years back when I was scheduled for an operation.

    Why their attitude? Maybe they think the problem will go away very soon and they don't think it's worthwhile to start you on something you may not need very soon. Or maybe your team just doesn't prescribe self cathing at all. They either use Foley's or operate. Some urologists are like that. 

    Jim

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    • Posted

      Further thoughts. Unless they are idiots, they aren't going to keep letting you go to the ER, so my guess is that unless they come with a fix very soon, they will put in a Foley. Not the worst thing in the world, if it's only for a few weeks to get the swelling down. Anything beyond that, self cathing would definitely be an option. 

      But again, I would really hear them out both as to why you are having difficulty urinating, how long they think this will last, how are they intending on dealing with the problem, and why they don't want you to self cath. You really have a right to know all these things. 

      Jim

       

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    • Posted

      I have to say, that my experience of catheter-and-bag made the distress and uncertainty and mental vertigo that I experienced when my system closed up, just that much worse.  Sleep was difficult, hiding a bag up my cargo shorts on a constructio site in August difficult, emptying the bag an additional hassle, etc., etc.    The office said wear the bag, and we can't get you in for whatever-test-was-next for FIVE WEEKS!!!   I said (To myself), "SCREW THAT!"  Changed doctors immediately when I found one who could get me in for that test a week later.  And after that week, I went to intermittent self-cathing.  Life suddenly got much better.

      Good luck, Tom!  Let us know what happens!

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    • Posted

      I hear you. When I was given the choice to wear a bag (Foley) for six weeks prior to my then scheduled TURP versus self cath, I chose self cath. Well, it turned out well because the self cathing empowered me enough to forgo the operation and now it's how I manage my BPH.

      That said, this is a different situation as surgery has already been done, and hopefully his inability to urinate is just temporary. In this case, I can see wearing the bag as a reasonable alternative. For some of us, I include myself here, the first few weeks of self cath can be h*ll, and the Foley would spare that even with its inconvenience, and hopefully only a one time thing. 

      Longer term, yes, self cath over Foley any day!

      Jim

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    • Posted

      Self catheterization was impossible for me, because even the urologist had a difficult time getting in and he had to use a scope. I was admitted through ER because kidney was shutting down due to tremendous volume of urine being retained. Finally after Greenlight Surgery last week and having a catheter for 7 weeks, it was removed. The urine came out but I do not have a feeling like when I want to go to the bathroom, I just stand in front of the toilet at certain times and it comes out, with a bit of a tingue of blood and it goes for about 2 minute. But I do not feel much as the urine is coming out nor do I feel I want to go. I was at the physician office for a post operative visit and he did an ultra sound and said there was 120ml of residual urine in bladder and he said that was a good number.  So I said to him I just drank about 800ml of fluid, he said it does not go by that, it goes by how much the ultrasound number says your retention is. But I have a question about that, I was going to the urologist all along every 3 months and he said I was retaining about 350ml consistently, but that did not help me after my symptoms with the severe constipation and for several weeks, with me frantically taking Milk of Magnesia and feeling like I could not walk up steps and was very weak. Finally they rushed me to ER and 10,000 ml came rushing out over 2 days. So my body was retaining waste product even though the Ultrasound only showed 350ml all the time. I had been frantically weightlifting constantly with only routines a young kid would do, and I do not know if maybe the combination of creatinine breakdown and the urinary retention superimposed on my system, caused this kidney shutdown. So when he tells me the ultrasound says there is only 120cc in your bladder of residual urine that is meaningless to me.  I just thought of that now, how do you know some urine is not automatically going backward in your system without a blood test to constantly monitor your Bun, Creatinine and Potassium. Also how is it explained as the urine comes out but I never feel like I have to urinate. I happened just now, woke up at 3.30am Central time USA and urine came out, but I have no feeling. I can not demand a blood test every few weeks from my physician telling him I want definite proof by BUN , creatinine that my body is not retaining fluid. My urologist is a hard working person and caring but how do I procede.
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  • Posted

    I would go back to the urologist who did the procedure and 1) find out what's going on 2) Get set up to self cath until its resolved. There are many stories of longer than advertised recoveries for the green light - you may be one, But the answer for you IMO is with the doc that performed the procedure, not the ER.
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  • Posted

    How recently did you have the procedure? I would ask for a suprapubic catheter for while until things settle down. It would be easier for you than trying to insert a catheter or going to ER.

     

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  • Posted

    I would see if possibly the bladder was damaged during the PVP procedure. I am just suggesting you have this checked out because I was recommended because my first Urologist recommended the PVP for my enlarged prostate but the 2nd Urologist said that because my Prostate was pushing into the bladder that there was a chance the laser could damage my bladder and did not think it was worth the risk.  (Of course, he did not do the PVP procedure so it could have been just a scare tactic for me to use him instead.)  I'm just wondering if that might be why you are having problems.  I don't mean to alarm you but I would ask for tests to see if the bladder was damaged.
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  • Posted

    Tom,

    Sorry to hear you are going through this. I went through the exact same thing after radiation to my prostate for prostate cancer. The radiation/green light causes tissue swelling and then you can't pee. I had to go to the ER 2 days post op with intense pain and 1200cc of urine blocked in my bladder. I had a Foley catheter put in, taken out, put in, taken out etc. 5 times over a 6 week period until the tissues settled down. I actually got used to the Foley after a while - easy.

    My urologist recommended self-cath, gave me an orange rubber re-usable cath, but every time I tried it I hated the process. Decided to stay on the Foley. During this process I sent for some sample hydrophilic (self lubricating) catheters and was able to get the process to work - not easy. After 5 weeks I was finally able to pee on my own. If anything like this happens again I still have the hydrophilic catheters ready. At least, if you absolutely can't pee, the self cath is better than going to the ER while you're in pain. 

    As has been mentioned here before, this situation should resolve over time - usually a few weeks. After that, you will never take peeing for granted again. 

    Best of luck to you,

    Tom

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    • Posted

      Is it possible that you have some blood clots in there that are keeping you from urinating? If so, you need to get a catheter in there and have them flush the clots out. Ask them about it and whatever else is causing your problems

      Neal

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    • Posted

      The priblem is something else.  Right after to operation I was able to urinate then it became difficult.  Then they prescribed Bethanechol 3X per day which causes the bladder to constrict if  you have a problem.

      I took the first pill in the office.  I was told to go and drink a lot then to com back in 3 hours.

      I went home, drank 64 ounces of Gatorade ans 2 8 ounces cups of coffee.  I came back to the office and peed LIKE A FIRE HOSE!  I thought "Great, they've got a handle on it."  From then on it was small amounts of urine .  Went bed and next morninbg I tried to go.  I went a little bit and I had to bear down myself.  That's why I went to ER.

      I want to get self cathing to give me freedom to consult with other doctors.

      I DID go after drinking more than any normal person drinksin 3 hours.

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